Almost 50 years ago, Dr. Tom Petty and his surgical colleagues identified 12 patients at the University of Colorado with similar clinical symptoms: severe hypoxemia, bilateral infiltrates on chest radiograph, and diminished static pulmonary compliance. The clinical features of these patients were published as a case series in the Lancet and serve as the initial description of the acute respiratory distress syndrome (ARDS). This seminal discovery launched a long and productive history of ARDS research in Denver. We have been a member of the ARDS Network since its inception in 1994. Our multi-disciplinary and collaborative critical care research group is experienced in conducting high quality multi-center clinical trials. As a result, we have always been one of the top enrolling ARDS Network sites for over 19 years. The University of Colorado's Department of Emergency Medicine was one of the first residency training programs in Emergency Medicine and remains one of most highly regarded training programs in the country. Their extramural funding has grown rapidly in the past decade especially in the area of critical care research. The Division of Pulmonary Sciences and Critical Care Medicine and the Department of Emergency Medicine have an established record of effective collaborations in both patient-oriented and research initiatives. Building on this ARDS Network research infrastructure, we will create an integrated Critical Care and Emergency Medicine clinical center to effectively conduct clinical trials for the prevention and early treatment of acute lung injury. This Colorado PETAL Clinical Center will exceed meet our enrollment obligations; maintain excellence in the quality of protocol compliance, data acquisition, and regulatory responsibilities; actively participate and contribute to the subsequent responsibilities of the steering and other PETAL committees; and contribute to the improved care of patients with and at risk for ARDS.